School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Rehabilitation, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
Division of Neonatology, Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan.
Early Hum Dev. 2022 Sep;172:105634. doi: 10.1016/j.earlhumdev.2022.105634. Epub 2022 Jul 28.
Although numerous studies have examined the development of preterm children born very low birth weight (VLBW, birth body weight < 1500 g), variations of developmental progress within individuals have rarely been explored. The aim of this research was to examine the cognitive and motor trajectories in preterm children born VLBW at early ages and to assess the risk factors and predictability of these trajectories.
Five hundred and eighty preterm infants born VLBW from three cohort studies (2003 to 2014) were prospectively assessed their mental and motor development using the Bayley Scales at 6, 12, 24, and 36 months, and cognitive, motor and behavioral outcomes using the Movement Assessment Battery for Children and the Child Behavior Checklist for Ages 1.5-5 at 4 years of age.
Preterm children born VLBW manifested three cognitive patterns (stably normal [64.0 %], deteriorating [31.4 %], and persistently delayed [4.6 %]) and four motor patterns (above average [6.3 %], stably normal [60.0 %], deteriorating [28.5 %], and persistently delayed [5.2 %]) during 6-36 months. Low birth body weight, stage III-IV retinopathy of prematurity and low parental socio-economic status were associated with the deteriorating patterns; prolonged hospitalization and major brain damage were additionally associated with the persistently delayed patterns. Furthermore, the cognitive and motor deteriorating pattern was each predictive of cognitive and motor impairment at 4 years of age; whereas, the persistently delayed patterns were predictive of multiple impairments.
Preterm children born VLBW display heterogeneous trajectories in early cognitive and motor development that predict subsequent developmental and behavioral outcomes.
尽管许多研究都考察了极低出生体重（VLBW，出生体重<1500 克）早产儿的发育情况，但个体内部发育进展的变化却很少被探讨。本研究旨在考察 VLBW 早产儿在早期的认知和运动轨迹，并评估这些轨迹的风险因素和可预测性。
本研究前瞻性评估了来自三个队列研究（2003 年至 2014 年）的 580 名 VLBW 早产儿的精神和运动发育情况，使用贝利婴幼儿发展量表在 6、12、24 和 36 个月时进行评估，并在 4 岁时使用运动评估电池和儿童行为检查表评估认知、运动和行为结果。
VLBW 早产儿出生的婴儿在 6-36 个月期间表现出三种认知模式（稳定正常[64.0%]、恶化[31.4%]和持续延迟[4.6%]）和四种运动模式（高于平均水平[6.3%]、稳定正常[60.0%]、恶化[28.5%]和持续延迟[5.2%]）。低出生体重、III 期至 IV 期早产儿视网膜病变和低父母社会经济地位与恶化模式相关；延长住院时间和主要脑损伤与持续延迟模式相关。此外，认知和运动恶化模式都预测了 4 岁时的认知和运动障碍；而持续延迟模式则预测了多种障碍。
VLBW 早产儿在早期认知和运动发育中表现出异质的轨迹，这些轨迹预测了随后的发育和行为结果。
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